Antigua Guatemala: Day 7

This little girl and I had quite a lot of fun doing a complete neurological exam after she fell and hit her head yesterday afternoon. Nothing is more fun than the finger-to-nose test.

























It was important to clear her for surgery since she was on the surgical schedule today—our last day in the operating room.









We’ll see her—and all the surgical patients—again tomorrow morning at our closing clinic. We cared for nearly 90 surgical patients over the last five days.



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Antigua Guatemala: Day 6

IMG_5912This is the left hand of a patient with amniotic band syndrome.

Strands develop in the amniotic fluid and wrap around the developing fetus. These bands can cut off the circulation to body parts and cause indentations and amputations.


This is the patient’s right hand. All of the bones of the wrist and fingers are present and have developed, but the skin over them was fused together. The surgeon was able to free up the patient’s thumb on this hand giving him better function.






One of the anesthesiologists pulled these separates off the scrub rack and scored fashion points today.









All 19 of today’s patients are all tucked in for the night. This baby who had a cleft lip repair is wearing no-no’s. They keep the baby from bending the arms at the elbow and putting their fingers or hands in the mouth and damaging the surgical repair.











The ruins of San Jose.







Tomorrow is our last day of surgery. There were fireworks in the central plaza tonight in anticipation of tomorrow, July 25th, St. James’s Day. He is the patron saint of Guatemala.


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Antigua Guatemala: Day 5

IMG_5945Better late than never. Two of our supply bags finally arrived today. They had IV sets and other equipment that we were able to find local replacements for. Today was a smooth day in the OR and on the floors. There are four rooms doing surgery-which is at least twenty patients a day.

Dinner at the hospital tonight on the wards was bread, meat, mashed potatoes and beans.




Before and after pictures of two different babies who had surgery today.




There was no consensus on coordinating our scrubs today. There’s lots to chose from!


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Antigua Guatemala: Day 3

Surgery starts at 7:30 in the morning. There are four surgeons operating at the same time in four separate rooms.

After surgery, patients come to the post operative care unit.

From there they go to the ward for the night.

Mid-day I walked to Case de Fe to check on tomorrow’s patients.




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Antigua Guatemala: Day 2

Today the Faces of Hope team saw 150 patients and set the schedule for the next five days of surgery.









After photos, we toured Obras Sociales del Hermano Pedro, our hospital.

















We held clinic upstairs with exam rooms that opened onto airy terraces.














Many families are Mayan and do not speak Spanish so there was three-way translation at times.








So many wonderful babies and children.




















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Antigua Guatemala: Day 1

IMG_5773.2The team made the flight from SFO to Guatemala City Friday. Two of our medical supply bags didn’t make the connection with us in Houston, and we are planning work arounds.

This is the first trip I am making with Faces of Hope, which is supported by Rotary. We have a full complement of surgeons, anesthesiologists, and nurses, along with respiratory, dental, and speech pathology. The patients and their families stay in Casa de Fe, a local guest house, since many travel here for treatment. The Casa de Fe team shopped today and bought 100 pounds of chicken, 50 pounds of potatoes, 200 plantains and bananas, 75 packages of beans and rice, 3 huge bags of sugar, 80 carrots the size of a forearm along with papayas, pineapples, and broccoli for the kitchen.

Tomorrow is clinic day. There are 130 patients to be evaluated for surgery. I am working with two Guatemalan pediatricians tomorrow, one of whom will stay on for the next few days.

Antigua Guatemala, founded in 1524, was largely abandoned after an earthquake in 1773. It is surrounded by three volcanos, and it is listed an UNESCO heritage site. Today there was just time for Cerro de la Cruz, the Catedral de Santiago and glimpses of school buses that may have taken me to school in a past life.






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Heat Illness and the Heat Index

Top athleteKids don’t adapt to extreme temperatures as well as adults. They generate more metabolic heat per mass when active, have a reduced capacity to sweat, and their high surface area to body mass ratio means they absorb more heat from the environment.

When it’s over 95 degrees F, kids’ exercise tolerance is lower than adults. Humidity only adds to heat stress. Getting used to exercising in the heat takes 8 to 10 exposures of 30-45 minutes each. These can be done one per day or one every other day.

Kids must drink to replace fluids lost during exercise, but they don’t always feel the need to drink enough. Dehydration increases the risk of heat stress and illness.

Children learn what the live, and adults should teach proper health habits in hot and humid weather: stress acclimatization, appropriate clothing, fluids and adjusting activities based on heat and humidity.

A chart that plots the Heat Index from temperature and humidity into relative risk zones is here. The colored zones indicate when parents, kids, coaches and players should exercise caution.

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Sports Nutrition

Play hard with sports nutrition. Click here to view larger or print.

Sports Nutrition


Book recommendations for information and recipes include:

The Feed Zone Cookbook: Fast and Flavorful Food for Athletes by Thomas and Lin—try the sweet potato and black bean burrito.

Feed Zone Portables by Thomas and Lin

Racing Weight by Matt Fitzgerald—includes meals plans for different sports

Thrive Energy Cookbook by Brendan Brazier—vegan

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Image from fever videoEveryone has a temperature. Not everyone has a fever.

Taking your child’s temperature helps you and the pediatrician make decisions about your child’s condition and recommended treatment.

A rectal temperature is recommended for children under 2 months of age.

There are many inexpensive digital thermometers to chose from. These are sold as oral and rectal.

Ear and forehead (temporal artery and infrared) thermometers are more appropriate for children over one year of age. Doctors don’t recommend temperature strips or pacifier thermometers.

For tips on taking your child’s temperature, see my Baby Center videos here.

For more information on the new infrared thermometers, see the article I contributed to in the Wall Street here


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School Physicals



Schools require a medical physical before a child enters.

See what’s this check up involves here.

For more back to school health health tips, read the Consumer’s Report article here.

Some insurance companies allow one physical examination every 365 days; other insurance companies allow one every calendar year.

If your child’s physical has slipped farther and farther into the year, call your insurance company’s customer service and ask if they allow the physical once each calendar year.


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